| NPI | 1063636454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 51431) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 51431) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2023-08-21 |