| NPI | 1144712274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 84396-20) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ R77037) |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2024-08-12 |