| NPI | 1568767937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101256058) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101256058) |
| Enumeration Date | 2011-01-17 |
| Last Update Date | 2020-10-02 |