| NPI | 1497102958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101276221) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD468642) |
| 207Q00000X Family Medicine (Licence: VA 0101276221) | |
| Enumeration Date | 2016-05-14 |
| Last Update Date | 2023-10-11 |