| NPI | 1730706425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2024043617) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO DR.0077029) |
| Enumeration Date | 2020-06-29 |
| Last Update Date | 2026-08-21 |