| NPI | 1588126668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2024006028) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 11912775-1205) |
| 207Q00000X Family Medicine (Licence: MO 2024006028) | |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2024-06-04 |