| NPI | 1780776302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 29331) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CO 29331) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2017-09-18 |