| NPI | 1073243846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101285982) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MDR-8266) |
| Enumeration Date | 2022-06-14 |
| Last Update Date | 2025-06-20 |