| NPI | 1124558135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2023-03317) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL40693) |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2024-03-25 |