| NPI | 1720490188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL MD.36317) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: SC 81874) |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2021-06-10 |