| NPI | 1669641155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 325716) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 239399) |
| 207R00000X Internal Medicine (Licence: MA 239399) | |
| 208M00000X Hospitalist (Licence: SC 51596) | |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2024-06-25 |