| NPI | 1851363881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 9500953) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 9500953) |
| 207Q00000X Family Medicine (Licence: NC 9500953) | |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2021-08-17 |