| NPI | 1629188651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IA MD-50064) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 025270) |
| 208M00000X Hospitalist (Licence: NE 16506) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2023-05-11 |