NPI | 1619123890 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 95353) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 204696) |
208M00000X Hospitalist (Licence: GA 95353) | |
Enumeration Date | 2008-08-07 |
Last Update Date | 2025-09-24 |