| NPI | 1629420575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 83379) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 008553) |
| Enumeration Date | 2016-07-04 |
| Last Update Date | 2025-04-08 |