| NPI | 1992934517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 56704) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 56704-20) |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2024-01-04 |