| NPI | 1700030848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101229833) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: VA 0101229833) |
| Enumeration Date | 2008-11-14 |
| Last Update Date | 2013-01-02 |