| NPI | 1356075246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 75608) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 9449) |
| 208M00000X Hospitalist (Licence: AZ 75608) | |
| Enumeration Date | 2022-07-15 |
| Last Update Date | 2025-07-15 |