| NPI | 1801232269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2015-02263) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 2015-02263) |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2017-01-18 |