| NPI | 1669098604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2024-01837) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL83274) |
| Enumeration Date | 2020-06-24 |
| Last Update Date | 2026-01-20 |