| NPI | 1780202259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 81263-20) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL16565) |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2023-10-24 |