NPI | 1932548880 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME147536) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 63962) |
207Q00000X Family Medicine (Licence: AZ R74064) | |
207Q00000X Family Medicine (Licence: WI 63962) | |
Enumeration Date | 2013-06-24 |
Last Update Date | 2025-09-16 |