| NPI | 1972819282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A118641) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA A118641) |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2026-07-16 |