| NPI | 1659697555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 8046571-1204) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E7997) |
| 207Q00000X Family Medicine (Licence: NV DO2419) | |
| 208M00000X Hospitalist (Licence: AR E7997) | |
| Enumeration Date | 2010-04-16 |
| Last Update Date | 2024-03-15 |