| NPI | 1164082905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A176598) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT217339) |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2026-01-14 |