| NPI | 1467195396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CT 80438) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 80438) |
| Enumeration Date | 2022-04-19 |
| Last Update Date | 2025-07-22 |