| NPI | 1093743296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME103608) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: GA 038084) |
| 208M00000X Hospitalist (Licence: SC 89617) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2023-05-12 |