| NPI | 1831624691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ID M-14391) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MRM-1631) |
| Enumeration Date | 2017-04-28 |
| Last Update Date | 2022-01-25 |