| NPI | 1154765998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A134430) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CT 56916) |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2026-07-02 |