| NPI | 1477936862 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD189783)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MRM-1500)  | 
| 208M00000X Hospitalist (Licence: CO CDR0000179)  | |
| 208M00000X Hospitalist (Licence: OR MD189783)  | |
| Enumeration Date | 2015-07-02 | 
| Last Update Date | 2025-09-28 |