| NPI | 1760890834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OK 5839) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 0058R) |
| Enumeration Date | 2014-08-01 |
| Last Update Date | 2026-03-17 |