| NPI | 1760747695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 82544) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 251986) |
| 207R00000X Internal Medicine (Licence: OR MD214909) | |
| 208M00000X Hospitalist (Licence: OR MD214909) | |
| Enumeration Date | 2012-07-06 |
| Last Update Date | 2025-07-21 |