| NPI | 1740222603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MI 4301102003) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01040707) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2018-01-23 |