| NPI | 1013124981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ND 10691) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL10039) |
| 207Q00000X Family Medicine (Licence: ND 10691) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2023-12-26 |