| NPI | 1841418506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101249734) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 19844) |
| 208M00000X Hospitalist (Licence: VA 0101249734) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2023-03-22 |