| NPI | 1659637122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C196407) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD469486) |
| 208M00000X Hospitalist (Licence: AL MD34474) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207Q00000X Family Medicine (Licence: AL MD34474) | |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2026-05-22 |