| NPI | 1306192372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL OS18845) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL 1615) |
| 207Q00000X Family Medicine (Licence: AL DO1515) | |
| 207Q00000X Family Medicine (Licence: FL OS18845) | |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2025-01-10 |