| NPI | 1265011621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2024027265) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 2024027265) |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2025-07-31 |