| NPI | 1588216469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ND 18541) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL15680) |
| 207Q00000X Family Medicine (Licence: ND 18541) | |
| 208M00000X Hospitalist (Licence: ND PT18541) | |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2023-12-28 |