| NPI | 1235342957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 11613219-1204) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A 9866) |
| 207Q00000X Family Medicine (Licence: HI dos1460) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2026-06-08 |