| NPI | 1083291603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 1022825) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MA 1022825) |
| Enumeration Date | 2021-03-28 |
| Last Update Date | 2026-04-13 |