| NPI | 1740643147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101271763) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101271763) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA 70100802) | |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2026-05-20 |