| NPI | 1275024267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL OS20715) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX S5572) |
| 207R00000X Internal Medicine (Licence: FL OS20715) | |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2025-09-26 |