| NPI | 1326508862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 30757) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NY 326688) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2026-04-27 |