| NPI | 1245964915 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NE 36983) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 9411) | 
| Enumeration Date | 2022-07-10 | 
| Last Update Date | 2025-08-20 |