| NPI | 1083844096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 57940) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101253383) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: VA 0101253383) | |
| 208M00000X Hospitalist (Licence: VA 0101253383) | |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2023-09-14 |