| NPI | 1952568834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 47386) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 047386) |
| 208M00000X Hospitalist (Licence: CT 47386) | |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2020-04-18 |