| NPI | 1417982158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A151031) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA A151031) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: AZ 71312) | |
| 363A00000X Physician Assistant (Licence: CA PA18295) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2026-07-02 |