| NPI | 1619381852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-13390) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: ID M-13390) |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2025-12-29 |