| NPI | 1316389372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 65797) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 65797-21) |
| 207R00000X Internal Medicine (Licence: IL 125-062888) | |
| Enumeration Date | 2013-07-18 |
| Last Update Date | 2025-06-18 |