| NPI | 1679132344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI MD-23502) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV 21469) |
| 208D00000X General Practice (Licence: NV 21469) | |
| 208M00000X Hospitalist (Licence: NV 21469) | |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2024-04-24 |