| NPI | 1629402003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS 13566) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL OS13566) |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2024-05-29 |