| NPI | 1659627925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2016-00495) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 2016-00495) |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2024-07-15 |