| NPI | 1184007072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2018-01968) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 2018-01968) |
| 207Q00000X Family Medicine (Licence: MI 4301108489) | |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2023-03-20 |