| NPI | 1255822706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 85675) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 1908R76805) |
| 207Q00000X Family Medicine (Licence: SC 85675) | |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2024-04-17 |