| NPI | 1376985630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IN 02005005A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 02005005A) |
| 207R00000X Internal Medicine (Licence: WV ED0400A) | |
| Enumeration Date | 2013-07-26 |
| Last Update Date | 2025-10-03 |