| NPI | 1487036224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 82709) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 082709) |
| 207Q00000X Family Medicine (Licence: MS 29353) | |
| Enumeration Date | 2015-06-28 |
| Last Update Date | 2023-09-18 |