| NPI | 1760114417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 76892) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 76892) |
| Enumeration Date | 2022-06-29 |
| Last Update Date | 2025-07-16 |