| NPI | 1821388901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CO DR.0055606) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34.010854) |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2016-12-05 |