| NPI | 1770042582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2022-00468) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL82241) |
| 208M00000X Hospitalist (Licence: NC 2022-00468) | |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2025-08-25 |