| NPI | 1679571863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E1018) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AR E-1018) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2023-06-21 |