| NPI | 1346220753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NM MD2010-0554) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA C137444) |
| 207Q00000X Family Medicine (Licence: WI 50553) | |
| 207Q00000X Family Medicine (Licence: NM MD2010-0554) | |
| 208M00000X Hospitalist (Licence: WI 50553-20) | |
| 208D00000X General Practice (Licence: VA 0101233901) | |
| 208M00000X Hospitalist (Licence: CA C137444) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2023-07-17 |