| NPI | 1659505238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT MED-PHYS-LIC-19823) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MT MED-PHYS-LIC-19823) |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2021-05-03 |