| NPI | 1386272672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL OS18613) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 18613) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2025-10-13 |