| NPI | 1134583180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 85029) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME138811) |
| 207R00000X Internal Medicine (Licence: SC 85029) | |
| 207R00000X Internal Medicine (Licence: NC 2019-01770) | |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2025-03-07 |