| NPI | 1497140081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 008151) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: GA 86297) |
| 207Q00000X Family Medicine (Licence: OH 35.133497) | |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2021-02-11 |