| NPI | 1417652850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 06364) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 06364) |
| 207R00000X Internal Medicine (Licence: IN 02009069A) | |
| 208M00000X Hospitalist (Licence: IN 02009069A) | |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2026-07-06 |