| NPI | 1861629966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL MD.41161) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: LA 205576) |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2021-02-24 |