| NPI | 1922560713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 74439-21) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 74439) |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2022-10-19 |