| NPI | 1306043773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301090618) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301090618) |
| 208M00000X Hospitalist (Licence: MI 4301090618) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2026-02-19 |