| NPI | 1891719365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101250653) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 058255) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2021-05-27 |