| NPI | 1215902432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101223743) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX T9090) |
| 207R00000X Internal Medicine (Licence: VA 0101223743) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2026-08-28 |