| NPI | 1154683530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A146695) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NV 15875) |
| 207R00000X Internal Medicine (Licence: NV 15875) | |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2025-12-27 |