| NPI | 1609261932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 81930) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101265865) |
| 207R00000X Internal Medicine (Licence: GA 81930) | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2026-09-23 |