| NPI | 1790363547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS19355) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL OS19355) |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2024-08-27 |