| NPI | 1407877343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 11791) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NV 11791) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2023-10-19 |