| NPI | 1750074639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A209986) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA A209986) |
| Enumeration Date | 2023-05-29 |
| Last Update Date | 2026-07-22 |