| NPI | 1689967796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OR MD179591) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 3887) |
| Enumeration Date | 2011-05-23 |
| Last Update Date | 2023-08-03 |