| NPI | 1164499216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2025-01619) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2025-01619) |
| 207R00000X Internal Medicine (Licence: CO 39426) | |
| 208M00000X Hospitalist (Licence: AK 147721) | |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2025-08-25 |