| NPI | 1467498501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY C1129) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX M7065) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2022-11-08 |