| NPI | 1073299319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4351050959) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KY TP817) |
| Enumeration Date | 2023-06-22 |
| Last Update Date | 2026-06-16 |