| NPI | 1538805213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 86256-20) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 86256-20) |
| Enumeration Date | 2022-05-06 |
| Last Update Date | 2025-09-11 |