| NPI | 1033367479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 34411) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 001796) |
| 207Q00000X Family Medicine (Licence: SC 34411) | |
| 207Q00000X Family Medicine (Licence: PA MD438845) | |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2019-08-27 |