| NPI | 1114668670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 76626) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AZ 76626) |
| Enumeration Date | 2022-04-06 |
| Last Update Date | 2025-10-15 |