| NPI | 1922009075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OK 26716) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301078867) |
| 207Q00000X Family Medicine (Licence: OK 26716) | |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2021-08-09 |