| NPI | 1164885836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 58564) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AZ 58564) |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2024-12-18 |