| NPI | 1619611100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MI 4301513100) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301513100) |
| Enumeration Date | 2022-04-21 |
| Last Update Date | 2025-08-26 |