| NPI | 1447734033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME161832) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX T3406) |
| Enumeration Date | 2018-09-19 |
| Last Update Date | 2024-04-08 |