| NPI | 1083891808 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2012-01940)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 50811)  | 
| 208M00000X Hospitalist (Licence: NC 2012-01940)  | |
| Enumeration Date | 2008-01-23 | 
| Last Update Date | 2025-05-08 |