| NPI | 1376630293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2026008581) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NY 243140-1) |
| 208M00000X Hospitalist (Licence: GA 031263) | |
| 207R00000X Internal Medicine (Licence: GA 31263) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2026-06-16 |