| NPI | 1891080479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2014-01442) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 33747) |
| 208M00000X Hospitalist (Licence: NC 2014-01442) | |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2023-10-28 |