| NPI | 1649850017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301518531) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MI 4301518531) |
| Enumeration Date | 2021-04-10 |
| Last Update Date | 2026-07-21 |