| NPI | 1902911068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME96707) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX T4586) |
| 208M00000X Hospitalist (Licence: FL ME96707) | |
| 208M00000X Hospitalist (Licence: CO DR.0062496) | |
| 207Q00000X Family Medicine (Licence: TX T4586) | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2024-04-22 |