| NPI | 1073182374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NE 35987) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 9083) |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2025-10-31 |