| NPI | 1306531892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0116038163) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 2026031078) |
| 207R00000X Internal Medicine (Licence: MO 2026031078) | |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2026-07-31 |