| NPI | 1225094071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL me97277) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME97277) |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2024-09-25 |