| NPI | 1972545176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX J9793) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0048631) |
| 208M00000X Hospitalist (Licence: CO DR.0048631) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2026-07-06 |