| NPI | 1689619678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 063689) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: SC 29624) |
| 207R00000X Internal Medicine (Licence: GA 063689) | |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2017-02-17 |