| NPI | 1154759025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL os14113) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL OS14113) |
| Enumeration Date | 2013-10-31 |
| Last Update Date | 2024-06-21 |