| NPI | 1144671710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL OS14210) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS14210) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: FL UO4433) | |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2022-03-21 |