| NPI | 1770105512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125.075766) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MD D0098465) |
| Enumeration Date | 2020-05-14 |
| Last Update Date | 2025-10-09 |