| NPI | 1861589897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101247768) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301086355) |
| 208M00000X Hospitalist (Licence: VA 0101247768) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2024-06-17 |