| NPI | 1457376881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 93945) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY 34OOA) |
| 207R00000X Internal Medicine (Licence: WY 7663A) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2023-08-01 |