| NPI | 1336184118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC MD12702) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: SC 12702) |
| 208M00000X Hospitalist (Licence: NC 2005-01259) | |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2023-04-14 |