| NPI | 1376772541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2020-04699) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-8586) |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2023-03-07 |