| NPI | 1619123890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 95353) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 204696) |
| 208M00000X Hospitalist (Licence: GA 95353) | |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2025-09-24 |