| NPI | 1720241862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 30953) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL30953) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2015-03-10 |