| NPI | 1093073991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2015-00367) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 2015-00367) |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2021-03-31 |