| NPI | 1164959656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: LA 341511) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 34.014389) |
| Enumeration Date | 2017-05-16 |
| Last Update Date | 2024-05-23 |