| NPI | 1932386752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OK 15992) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OK 15992) |
| 208D00000X General Practice (Licence: OK 15992) | |
| Enumeration Date | 2008-01-23 |
| Last Update Date | 2010-08-11 |