| NPI | 1326292962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME149104) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60194690) |
| 208M00000X Hospitalist (Licence: WV 27073) | |
| Enumeration Date | 2008-11-10 |
| Last Update Date | 2021-07-13 |