| NPI | 1124604202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A204214) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A204214) |
| Enumeration Date | 2021-03-20 |
| Last Update Date | 2025-10-01 |