| NPI | 1710563259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-16228) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AR E-16228) |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2024-10-29 |