| NPI | 1811150469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101248465) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D68446) |
| 207Q00000X Family Medicine (Licence: KY 41694) | |
| 208M00000X Hospitalist (Licence: VA 0101248465) | |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2024-11-04 |