| NPI | 1669609327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 44333) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA A118174) |
| 207Q00000X Family Medicine (Licence: CA A118174) | |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2012-12-11 |