| NPI | 1235536897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 110404) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AZ 54216) |
| 207R00000X Internal Medicine (Licence: AZ 54216) | |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2026-06-29 |