| NPI | 1053762179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2023-03354) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL39578) |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2024-04-24 |