| NPI | 1407242498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2025001996) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E-11570) |
| 208M00000X Hospitalist (Licence: TN 60226) | |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2025-07-24 |