| NPI | 1114512258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A206317) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A206317) |
| 207R00000X Internal Medicine (Licence: VA 0101276254) | |
| Enumeration Date | 2021-03-01 |
| Last Update Date | 2026-10-06 |