| NPI | 1508428632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-49130) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4351045651) |
| 207Q00000X Family Medicine (Licence: MO 2023010819) | |
| 208M00000X Hospitalist (Licence: MI 4351045651) | |
| Enumeration Date | 2019-06-28 |
| Last Update Date | 2024-04-02 |