| NPI | 1255309340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL OS7739) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS7739) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2026-02-17 |