| NPI | 1811330160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: LA 301275) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 301275) |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2021-06-07 |