| NPI | 1295173078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301103320) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MI 4301103320) |
| 207R00000X Internal Medicine (Licence: CT 57188) | |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2025-09-15 |