| NPI | 1780813667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OR MD165945) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD165945) |
| 207Q00000X Family Medicine (Licence: IN 11015176A) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: OR MD165945) | |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2023-06-27 |