| NPI | 1205263266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KS 05-46627) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 2969) |
| 207Q00000X Family Medicine (Licence: FL UO 3474) | |
| 208M00000X Hospitalist (Licence: FL OS13306) | |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2023-03-06 |