| NPI | 1700877677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2005-01930) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME94204) |
| 208M00000X Hospitalist (Licence: NC 2005-01930) | |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2022-02-10 |