NPI | 1558673152 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2017011098) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 2017011098) |
207Q00000X Family Medicine (Licence: TX BP1-0037472) | |
208M00000X Hospitalist (Licence: IL 036132314) | |
Enumeration Date | 2010-07-12 |
Last Update Date | 2023-05-23 |