| NPI | 1730716515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 103606) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: SC 90458) |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2025-03-18 |