| NPI | 1407525363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 83047-20) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 83047-20) |
| Enumeration Date | 2021-09-13 |
| Last Update Date | 2024-12-18 |