NPI | 1104189331 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101258993) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT202730) |
Enumeration Date | 2012-06-22 |
Last Update Date | 2023-03-03 |