| NPI | 1235795501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME147432) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 65955) |
| 208M00000X Hospitalist (Licence: AZ 65955) | |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2025-07-24 |