| NPI | 1073805438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 92433) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: GA 92433) |
| 207R00000X Internal Medicine (Licence: AL MD.33519) | |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2025-09-22 |