| NPI | 1922458850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC LL39788) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CO DR.0062649) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2019-08-05 |