| NPI | 1477127298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101282166) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101282166) |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2024-08-06 |