| NPI | 1316687106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NV 27815) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV 27815) |
| Enumeration Date | 2022-03-30 |
| Last Update Date | 2025-07-26 |