| NPI | 1881986164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101272781) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: PA MD452723) |
| Enumeration Date | 2011-05-05 |
| Last Update Date | 2021-08-19 |