| NPI | 1265096184 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 343993) | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: LA 343993) | 
| 207R00000X Internal Medicine (Licence: IL 125077221) | |
| Enumeration Date | 2019-04-25 | 
| Last Update Date | 2025-09-25 |