| NPI | 1639858798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125.081774) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KY 61977) |
| Enumeration Date | 2023-07-17 |
| Last Update Date | 2026-07-01 |