| NPI | 1588878508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AZ 37192) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AZ 37192) |
| 207R00000X Internal Medicine (Licence: AZ 37192) | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2026-03-16 |