| NPI | 1679059638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ND 21753) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX T8219) |
| 207R00000X Internal Medicine (Licence: ND RL15186) | |
| Enumeration Date | 2018-07-12 |
| Last Update Date | 2025-09-29 |