| NPI | 1003445990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2023027651) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2020019358) |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2023-08-15 |