| NPI | 1053762641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5315095269) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MI 5315095269) |
| Enumeration Date | 2016-06-25 |
| Last Update Date | 2023-11-03 |