| NPI | 1295409910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ND 20584) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL17360) |
| Enumeration Date | 2021-08-05 |
| Last Update Date | 2024-09-04 |