| NPI | 1134782121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AK 193577) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK 146377) |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2022-08-25 |