| NPI | 1720044811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CT 042567) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 042567) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2008-03-10 |