| NPI | 1215279203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 86278) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35127469) |
| 207Q00000X Family Medicine (Licence: OK 33560) | |
| Enumeration Date | 2013-03-18 |
| Last Update Date | 2021-08-20 |