| NPI | 1114904745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MO 109410) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 109410) |
| 207P00000X Emergency Medicine (Licence: MO 109410) | |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2026-04-23 |