| NPI | 1134821929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2023022770) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2023022770) |
| Enumeration Date | 2023-03-17 |
| Last Update Date | 2026-04-15 |