| NPI | 1942248919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: LA MD.024213) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 024213) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2021-02-26 |