| NPI | 1386211506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 99609) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: UT 14274535-1205) |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2026-04-07 |