| NPI | 1649733437 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV DO3187)  | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NV DO3187)  | 
| Enumeration Date | 2019-04-09 | 
| Last Update Date | 2024-06-16 |