| NPI | 1679885511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2010-01295) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: SC 32904) |
| 207R00000X Internal Medicine (Licence: SC 32904) | |
| 207R00000X Internal Medicine (Licence: NC 2010-01295) | |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2026-03-31 |