| NPI | 1053057422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MA 1023359) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R79474) |
| Enumeration Date | 2022-05-09 |
| Last Update Date | 2025-06-21 |