| NPI | 1801959721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 28288-20) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 28288) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2015-01-12 |