| NPI | 1396236469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS19154) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL OS19154) |
| 208M00000X Hospitalist (Licence: TX V7777) | |
| 207Q00000X Family Medicine (Licence: OH 34C.000622) | |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2026-02-05 |