| NPI | 1154534303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 38788) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL MD.38189) |
| 207Q00000X Family Medicine (Licence: MI 4301086102) | |
| 207Q00000X Family Medicine (Licence: GA 65599) | |
| 208M00000X Hospitalist (Licence: AL 38189) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2020-02-20 |