| NPI | 1093101511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 79910) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 1093101511) |
| 208M00000X Hospitalist (Licence: GA 79910) | |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2024-12-31 |