| NPI | 1114066115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 17098) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM 2006-0432) |
| 208M00000X Hospitalist (Licence: WV 27280) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2021-10-19 |