| NPI | 1184691305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: MO 2005025981) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2005025981) |
| 208M00000X Hospitalist (Licence: MO 2005025981) | |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2023-03-07 |