| NPI | 1144627134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 6266) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OK 6226) |
| Enumeration Date | 2014-11-19 |
| Last Update Date | 2020-10-02 |