| NPI | 1083963128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 69209) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD449838) |
| 207R00000X Internal Medicine (Licence: AZ 69209) | |
| Enumeration Date | 2012-09-05 |
| Last Update Date | 2025-07-29 |