| NPI | 1942287453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 46538) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TN 27286) |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2010-02-18 |