| NPI | 1023646734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 102871) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AR E-15911) |
| Enumeration Date | 2020-03-29 |
| Last Update Date | 2025-03-24 |