| NPI | 1851611834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2016-00426) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101252753) |
| 207Q00000X Family Medicine (Licence: NC 2016-00426) | |
| Enumeration Date | 2010-06-01 |
| Last Update Date | 2023-03-15 |