| NPI | 1316263064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60475120) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 69202) |
| 208M00000X Hospitalist (Licence: WI 69202) | |
| 207R00000X Internal Medicine (Licence: FL ME174341) | |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2025-09-05 |