| NPI | 1093158685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME134163) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 191427) |
| 208M00000X Hospitalist (Licence: NC 2016-00466) | |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2022-04-29 |