| NPI | 1861978074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2019033221) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 2019033221) |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2024-07-11 |