| NPI | 1811340201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 6727) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TN 6727) |
| 207Q00000X Family Medicine (Licence: MS 25373) | |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2026-07-01 |