| NPI | 1548614563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NV DO2524) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV DO2524) |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2025-06-16 |