| NPI | 1700373313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME172967) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.148874) |
| 207R00000X Internal Medicine (Licence: IL 036167781) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: OH 35.148874) | |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2025-06-23 |