| NPI | 1548753841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 92103) |
| Additional Taxonomies | 208D00000X General Practice (Licence: GA 00000000000) |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2022-09-21 |