| NPI | 1205271145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2014-00429) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 61081-20) |
| 208M00000X Hospitalist (Licence: NC 2014-00429) | |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2022-12-05 |