NPI | 1033550421 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208M00000X Hospitalist (Licence: NE 29422) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 29422) |
207Q00000X Family Medicine (Licence: IA MD-43770) | |
207Q00000X Family Medicine (Licence: NE 7117) | |
208M00000X Hospitalist (Licence: IA MD-43770) | |
Enumeration Date | 2013-07-12 |
Last Update Date | 2021-06-16 |