| NPI | 1972585446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 50236) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 050236) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2021-02-19 |