| NPI | 1891956371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WY 11576A) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WY 11576A) |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2022-11-03 |