| NPI | 1336120690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS12047) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL OS12047) |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2024-08-23 |