| NPI | 1629496880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 078999) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 20123) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2026-01-07 |