| NPI | 1679673925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 076172) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01062878A) |
| 207Q00000X Family Medicine (Licence: FL ME 110891) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2018-03-17 |