| NPI | 1053453159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A117461) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OR MD27911) |
| 207R00000X Internal Medicine (Licence: MN 55989) | |
| 208M00000X Hospitalist (Licence: OR MD215275) | |
| 207R00000X Internal Medicine (Licence: OR MD27911) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 55989) | |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2026-05-20 |