| NPI | 1003494683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 77312) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 77312) |
| 208000000X Pediatrics (Licence: AZ 77312) | |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2025-07-24 |