| NPI | 1477821155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 77026) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2018004381) |
| 207Q00000X Family Medicine (Licence: IL 134079) | |
| 207Q00000X Family Medicine (Licence: SC 37435) | |
| 207Q00000X Family Medicine (Licence: TX Q0769) | |
| 207Q00000X Family Medicine (Licence: GA 77026) | |
| Enumeration Date | 2011-12-08 |
| Last Update Date | 2020-12-28 |