| NPI | 1497833438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 47790) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 47790) |
| 207QH0002X Family Medicine Hospice and Palliative Medicine (Licence: WI 47790) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2025-07-07 |