| NPI | 1659723815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ND 15873) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL 14125) |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2023-12-22 |