| NPI | 1689962409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2016014756) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL MD.47234) |
| Enumeration Date | 2011-07-13 |
| Last Update Date | 2025-07-29 |