| NPI | 1154064459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 011789) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR PG211304) |
| 208D00000X General Practice (Licence: OR DO223662) | |
| 207R00000X Internal Medicine (Licence: AZ 011789) | |
| Enumeration Date | 2022-04-15 |
| Last Update Date | 2025-10-08 |