NPI | 1962865931 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A156934) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2025-0356) |
207Q00000X Family Medicine (Licence: CA A156934) | |
208M00000X Hospitalist (Licence: TX U6738) | |
Enumeration Date | 2016-03-29 |
Last Update Date | 2025-05-21 |