| NPI | 1174752802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IA 04409) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA DO-04409) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2023-01-03 |