| NPI | 1053623884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 34806) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036172469) |
| 207P00000X Emergency Medicine (Licence: TX R0668) | |
| 207Q00000X Family Medicine (Licence: LA MD.208189) | |
| 207Q00000X Family Medicine (Licence: OK 29066) | |
| 207Q00000X Family Medicine (Licence: IN 01071413A) | |
| 208M00000X Hospitalist (Licence: WV 34806) | |
| 207Q00000X Family Medicine (Licence: TX R0668) | |
| Enumeration Date | 2010-07-09 |
| Last Update Date | 2025-05-14 |