| NPI | 1982890836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: LA 023532) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 23532) |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2016-04-07 |