| NPI | 1013692805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2026021216) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2026021216) |
| Enumeration Date | 2023-06-19 |
| Last Update Date | 2026-07-06 |