| NPI | 1932337706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ND 12013) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 61703) |
| 207Q00000X Family Medicine (Licence: ND 12013) | |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2023-02-10 |