| NPI | 1417498379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 284291) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MA 284291) |
| Enumeration Date | 2017-03-12 |
| Last Update Date | 2025-05-28 |