| NPI | 1942731229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 68369) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VT 042-0014821) |
| 208M00000X Hospitalist (Licence: VT 042-0014821) | |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2023-08-15 |