| NPI | 1467143453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5151016176) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MI 5315267332) |
| Enumeration Date | 2023-05-19 |
| Last Update Date | 2026-06-29 |