| NPI | 1346687852 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL OS16800) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS16800) | 
| Enumeration Date | 2013-05-24 | 
| Last Update Date | 2024-12-23 |