| NPI | 1407434376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2025035238) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102208575) |
| 207R00000X Internal Medicine (Licence: MO 2025035238) | |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2025-08-26 |