| NPI | 1003202946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: LA 310930) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 310930) |
| 208M00000X Hospitalist (Licence: FL ME181610) | |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2026-05-20 |