| NPI | 1073928693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2018002737) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2015031715) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2020-02-24 |