| NPI | 1235583410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A158027) |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine (Licence: CA A158027) |
| 207Q00000X Family Medicine (Licence: OH 35.134815) | |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2023-10-16 |