| NPI | 1871939926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2016-01340) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 2016-01340) |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2021-08-21 |