| NPI | 1578940623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2019-01133) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 2019-01133) |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2025-12-23 |