| NPI | 1689236754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 334325) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 74287) |
| 207R00000X Internal Medicine (Licence: WI 7671-851) | |
| 208M00000X Hospitalist (Licence: WI 74287) | |
| Enumeration Date | 2019-06-28 |
| Last Update Date | 2025-06-10 |