| NPI | 1700407459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A204688) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A204688) |
| 208M00000X Hospitalist (Licence: HI MD-24569) | |
| Enumeration Date | 2020-05-05 |
| Last Update Date | 2025-10-01 |