| NPI | 1316563471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NM DO2023-1025) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL UO7401) |
| Enumeration Date | 2020-06-24 |
| Last Update Date | 2023-07-31 |