| NPI | 1316238231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 33512) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AL MD.33512) |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2026-03-12 |