| NPI | 1003844754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 23538) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AL MD.23538) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2025-10-02 |