| NPI | 1548526965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A135870) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA A135870) |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2024-09-25 |