| NPI | 1063867554 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL OS16496) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS16496) | 
| Enumeration Date | 2016-05-03 | 
| Last Update Date | 2025-01-08 |