| NPI | 1881170702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 52641) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL52641) |
| Enumeration Date | 2018-07-13 |
| Last Update Date | 2021-09-14 |