| NPI | 1205195443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 5464) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OK 5464) |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2025-09-03 |