| NPI | 1518919380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 52615) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 9900525) |
| 207Q00000X Family Medicine (Licence: GA 058190) | |
| 207Q00000X Family Medicine (Licence: WV 22988) | |
| 207Q00000X Family Medicine (Licence: NY 243170-1) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2019-01-14 |