NPI | 1497102958 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NC 202302127) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD468642) |
207Q00000X Family Medicine (Licence: VA 0101276221) | |
208M00000X Hospitalist (Licence: VA 0101276221) | |
Enumeration Date | 2016-05-14 |
Last Update Date | 2025-08-14 |