| NPI | 1336107770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KS 0447995) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 0447995) |
| 207Q00000X Family Medicine (Licence: VA 0101234752) | |
| 208M00000X Hospitalist (Licence: CO DR.0062929) | |
| 208M00000X Hospitalist (Licence: VA 0101234752) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2024-06-18 |