| NPI | 1245882372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 69323) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 69323) |
| 207R00000X Internal Medicine (Licence: NE 8531) | |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2025-09-23 |