| NPI | 1508398678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OK 45323) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: LA 340785) |
| 207R00000X Internal Medicine (Licence: TN 61690) | |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2025-10-30 |