| NPI | 1851731525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 59939) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 29819) |
| 208M00000X Hospitalist (Licence: OH 35.128523) | |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2021-09-15 |