NPI | 1972591725 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 200301259) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 200301259) |
Enumeration Date | 2005-10-06 |
Last Update Date | 2019-07-23 |