| NPI | 1720070675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MT 11694) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AZ 44501) |
| 207R00000X Internal Medicine (Licence: MT 11694) | |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2025-09-22 |