| NPI | 1508187824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A144892) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A144892) |
| 208M00000X Hospitalist (Licence: NM MD2013-0265) | |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2022-04-01 |