| NPI | 1114651650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ND 22007) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125079821) |
| 207R00000X Internal Medicine (Licence: ND 22007) | |
| Enumeration Date | 2022-07-11 |
| Last Update Date | 2025-07-29 |