| NPI | 1518464007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TN 5523) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 72267-21) |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2026-06-10 |