| NPI | 1568102739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 91064) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL87632) |
| 208M00000X Hospitalist (Licence: SC 91064) | |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2025-09-29 |