| NPI | 1730117110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2018-00658) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 11107) |
| 208M00000X Hospitalist (Licence: NH 11107) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2019-04-18 |