| NPI | 1841231941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301073786) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MI 4301073786) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2016-03-16 |