| NPI | 1356754154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 37054) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 37054) |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2025-12-16 |