| NPI | 1356460190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME149075) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 178711) |
| 207Q00000X Family Medicine (Licence: OH 35.098496) | |
| 207Q00000X Family Medicine (Licence: SC LL28793) | |
| 207Q00000X Family Medicine (Licence: KY 42771) | |
| 208M00000X Hospitalist (Licence: OH 35.098496) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2021-09-22 |