| NPI | 1033731161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MT MED-PHYS-LIC-127964) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT MED-PHYS-LIC-127964) |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2023-09-06 |