| NPI | 1730119702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME76454) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MI 4301089242) |
| 207R00000X Internal Medicine (Licence: MI 4301089242) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2026-07-23 |