| NPI | 1053632935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2009018166) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 2009018166) |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2023-03-07 |