| NPI | 1558823278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 46720) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101279106) |
| 207R00000X Internal Medicine (Licence: NC 2022-01770) | |
| 208M00000X Hospitalist (Licence: VA 0101279106) | |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2026-03-13 |