| NPI | 1194345579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2024041686) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 35765) |
| Enumeration Date | 2020-04-25 |
| Last Update Date | 2025-09-18 |