| NPI | 1093196586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2021041431) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2015017250) |
| Enumeration Date | 2015-06-10 |
| Last Update Date | 2021-10-20 |