| NPI | 1770559775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO R8764) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO R8764) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2021-09-27 |