| NPI | 1316637945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MA 1027815) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI 05876) |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2026-06-26 |