| NPI | 1063855047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 93559) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 2017006922) |
| 207R00000X Internal Medicine (Licence: MO 2017006922) | |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2025-09-15 |