| NPI | 1801258611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VT 042.0014423) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0059517) |
| 207Q00000X Family Medicine (Licence: CO TL.0006164) | |
| 207Q00000X Family Medicine (Licence: VT 042.0014423) | |
| 208M00000X Hospitalist (Licence: CO DR.0059517) | |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2023-01-09 |