| NPI | 1942837042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: CO DR.0071152) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX T8017) |
| 208M00000X Hospitalist (Licence: CO DR.0071152) | |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2026-03-19 |