| NPI | 1093212920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WY 14235A) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: ND 17998) |
| 207R00000X Internal Medicine (Licence: CO DR.0065859) | |
| Enumeration Date | 2018-04-08 |
| Last Update Date | 2026-03-20 |