| NPI | 1194175562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 008358) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: SC 89064) |
| 208M00000X Hospitalist (Licence: TN 63504) | |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2026-04-07 |