| NPI | 1629521075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME161424) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AL 38489) |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2025-10-22 |