| NPI | 1609139500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 48765) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 30716) |
| 208M00000X Hospitalist (Licence: AZ 48765) | |
| Enumeration Date | 2012-06-17 |
| Last Update Date | 2019-08-26 |