| NPI | 1316987100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2016-02203) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 15188) |
| 207Q00000X Family Medicine (Licence: NC 2016-02203) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2024-05-10 |