| NPI | 1245612175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MT 176106) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2024010147) |
| 208M00000X Hospitalist (Licence: MO 2024010147) | |
| Enumeration Date | 2015-06-27 |
| Last Update Date | 2026-10-14 |