| NPI | 1952366890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OR MD18697) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD18697) |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2017-12-07 |