| NPI | 1255534343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2010-01570) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 33962) |
| 208M00000X Hospitalist (Licence: NC 2010-01570) | |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2026-03-19 |