| NPI | 1104121193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01081857A) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 1790) |
| 207R00000X Internal Medicine (Licence: MA 261992) | |
| 207R00000X Internal Medicine (Licence: KY 50173) | |
| 207R00000X Internal Medicine (Licence: MD D72494) | |
| Enumeration Date | 2011-01-21 |
| Last Update Date | 2026-03-23 |