| NPI | 1750762209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 91190) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 61302) |
| 208M00000X Hospitalist (Licence: GA 91190) | |
| 208M00000X Hospitalist (Licence: CT 61302) | |
| Enumeration Date | 2015-06-10 |
| Last Update Date | 2025-04-04 |