| NPI | 1083177224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IA MD-51235) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 77345) |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2023-07-13 |