| NPI | 1629650304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OK 47657) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01089779B) |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2026-06-17 |