| NPI | 1154956415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A193249) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101273973) |
| Enumeration Date | 2020-03-06 |
| Last Update Date | 2025-01-06 |