| NPI | 1508185992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL FS3811898) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: VA 0101253685) |
| 207Q00000X Family Medicine (Licence: VA 0101253685) | |
| Enumeration Date | 2010-05-25 |
| Last Update Date | 2026-01-26 |