| NPI | 1871278515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 8689) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OK 8689) |
| Enumeration Date | 2023-06-20 |
| Last Update Date | 2026-10-23 |