| NPI | 1235794884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CO DR.0073531) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV SL1436) |
| 207R00000X Internal Medicine (Licence: NV DO3112) | |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2025-04-30 |