| NPI | 1003255654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A166689) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A166689) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2026-04-08 |