| NPI | 1053937888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ND 19611) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND 16680) |
| Enumeration Date | 2020-06-17 |
| Last Update Date | 2023-12-27 |