| NPI | 1376170605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 81450) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX U9713) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2025-07-18 |