| NPI | 1154577310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KS 04-38959) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 2024047121) |
| 207R00000X Internal Medicine (Licence: NM MD2013-0824) | |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2025-09-08 |