| NPI | 1942439161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 074684) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 2021-03316) |
| 208M00000X Hospitalist (Licence: GA 074684) | |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2024-10-03 |