| NPI | 1700221272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NV 19078) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV 19078) |
| 207Q00000X Family Medicine (Licence: MT 42149) | |
| 208M00000X Hospitalist (Licence: AK 127834) | |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2024-06-16 |