| NPI | 1770102253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 69705) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 69705) |
| 207R00000X Internal Medicine (Licence: CA A200677) | |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2025-12-14 |