| NPI | 1679138002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2023-00006) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 202300006) |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2025-08-25 |