NPI | 1053607457 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208M00000X Hospitalist (Licence: OR MD182996) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD182996) |
207Q00000X Family Medicine (Licence: MI 4301099178) | |
Enumeration Date | 2011-06-23 |
Last Update Date | 2023-01-18 |