| NPI | 1689861866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CT 48107) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 48107) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2015-02-06 |