| NPI | 1245591775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102205247) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD H79404) |
| 208M00000X Hospitalist (Licence: VA 0102205247) | |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2021-03-11 |