| NPI | 1174291264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MS 31787) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 31787) |
| Enumeration Date | 2021-09-02 |
| Last Update Date | 2024-10-07 |