| NPI | 1619058880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 33100) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AZ 33100) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2026-08-20 |