| NPI | 1477057461 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 89384) | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: GA 89384) | 
| Enumeration Date | 2018-03-22 | 
| Last Update Date | 2024-06-11 |