| NPI | 1376289819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 77897) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ R79503) |
| Enumeration Date | 2022-05-09 |
| Last Update Date | 2025-11-10 |