| NPI | 1295387967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 179436) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD480432) |
| 208M00000X Hospitalist (Licence: PA MD480432) | |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2025-11-14 |