| NPI | 1619296050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 73748) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AZ 73748) |
| Enumeration Date | 2010-05-25 |
| Last Update Date | 2024-09-12 |