| NPI | 1982022638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2016-02229) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2016-02229) |
| 208M00000X Hospitalist (Licence: NC 2016-02229) | |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2025-09-25 |