| NPI | 1831716224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ND 20123) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL16707) |
| Enumeration Date | 2020-07-01 |
| Last Update Date | 2024-02-01 |