| NPI | 1588345722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MT 169805) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP06077) |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2026-06-10 |