| NPI | 1952536088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 17577) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: PR 17577) |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2012-09-14 |