| NPI | 1780630046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 94-00308) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 9400308) |
| 208M00000X Hospitalist (Licence: NC 9400308) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2015-10-20 |