| NPI | 1013443282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 78415) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX S0932) |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2025-10-30 |