| NPI | 1669766598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX U2245) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI MD14600) |
| 207QS1201X Family Medicine, Sleep Medicine (Licence: TX U2245) | |
| 208M00000X Hospitalist (Licence: PA MD467329) | |
| 207Q00000X Family Medicine (Licence: PA MD467329) | |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2026-10-01 |