| NPI | 1154649945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO179739) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA 4451) |
| 208M00000X Hospitalist (Licence: IA 4451) | |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2022-04-05 |