| NPI | 1649547712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PR 19269) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IN 01079100A) |
| Enumeration Date | 2011-11-17 |
| Last Update Date | 2021-06-02 |