| NPI | 1538470877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: FL uo2277) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL 0s12737) |
| 207R00000X Internal Medicine (Licence: FL uo2277) | |
| 207R00000X Internal Medicine (Licence: MA MA244984) | |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2021-03-15 |