| NPI | 1508123183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME166124) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD172397) |
| 208M00000X Hospitalist (Licence: OR MD172397) | |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2024-04-23 |