| NPI | 1700823697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AL MD.26531) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 26531) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2023-07-13 |