| NPI | 1194378125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: LA 332769) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 332769) |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2026-06-10 |