| NPI | 1639460884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2014-01564) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 2014-01564) |
| Enumeration Date | 2011-04-22 |
| Last Update Date | 2024-01-29 |