| NPI | 1659805059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 82948-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 9453) |
| 208M00000X Hospitalist (Licence: WI 82948-20) | |
| 208M00000X Hospitalist (Licence: GA 85835) | |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2025-10-23 |