| NPI | 1407206477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 19464) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NH 19464) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2023-09-12 |