| NPI | 1013388545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WY 13210A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0069580) |
| 207Q00000X Family Medicine (Licence: WY TL6376) | |
| 208M00000X Hospitalist (Licence: CO DR.0069580) | |
| 208M00000X Hospitalist (Licence: WY TL6376) | |
| 208M00000X Hospitalist (Licence: WY 13210A) | |
| Enumeration Date | 2015-10-09 |
| Last Update Date | 2022-09-21 |