| NPI | 1699094201 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CT 53426)  | 
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: CT 53426)  | 
| Enumeration Date | 2010-05-21 | 
| Last Update Date | 2014-08-07 |