| NPI | 1619544293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NV DO3850) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: ND 20259) |
| Enumeration Date | 2021-06-10 |
| Last Update Date | 2025-04-16 |