| NPI | 1376658872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101278673) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AZ 70492) |
| 207R00000X Internal Medicine (Licence: MD D63653) | |
| 207R00000X Internal Medicine (Licence: LA 336633) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2026-01-21 |