| NPI | 1962938803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101267223) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 101267223) |
| 208M00000X Hospitalist (Licence: VA 0101267223) | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2021-10-05 |