| NPI | 1194342360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101028352) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 011390) |
| 208M00000X Hospitalist (Licence: AZ 011390) | |
| 208M00000X Hospitalist (Licence: MI 5101028352) | |
| Enumeration Date | 2020-07-02 |
| Last Update Date | 2025-08-13 |