| NPI | 1104449362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0102206754) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: VA 0102206754) |
| Enumeration Date | 2020-05-22 |
| Last Update Date | 2026-07-27 |