| NPI | 1972985091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2018000037) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2015018544) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2020-03-16 |