| NPI | 1215911623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101226303) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101226303) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2023-03-06 |