| NPI | 1437641883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 76159) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME146861) |
| 208M00000X Hospitalist (Licence: TX T8721) | |
| 207Q00000X Family Medicine (Licence: FL ME146861) | |
| 207Q00000X Family Medicine (Licence: TX T8721) | |
| 207Q00000X Family Medicine (Licence: ND 17363) | |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2025-11-06 |