| NPI | 1699156281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A144643) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: GU M-2473) |
| 207Q00000X Family Medicine (Licence: GU M-2473) | |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2026-04-30 |