| NPI | 1932691862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 16497) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL15104) |
| 208M00000X Hospitalist (Licence: ND 16497) | |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2021-07-30 |