| NPI | 1568984342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ TP00513) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301113301) |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2020-09-21 |