| NPI | 1255304697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 04-45914) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: VA 0101042805) |
| 207R00000X Internal Medicine (Licence: NC 2022-01804) | |
| 207R00000X Internal Medicine (Licence: VA 0101042805) | |
| 208M00000X Hospitalist (Licence: KS 04-45914) | |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2026-02-24 |