| NPI | 1659311611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 9855) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: PR 9855) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2022-07-21 |