| NPI | 1154908671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OR MD218844) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD218844) |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2025-09-09 |