| NPI | 1154716223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME163864) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE C1-0012716) |
| 207Q00000X Family Medicine (Licence: CA A153501) | |
| 208M00000X Hospitalist (Licence: DE C1-0012716) | |
| Enumeration Date | 2015-04-05 |
| Last Update Date | 2025-07-09 |