| NPI | 1184707879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 55486) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 055486) |
| 208M00000X Hospitalist (Licence: GA 055486) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2026-09-02 |