| NPI | 1770166563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.150404) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 76861) |
| 207R00000X Internal Medicine (Licence: OH 35.150404) | |
| 208M00000X Hospitalist (Licence: AZ 76861) | |
| Enumeration Date | 2021-04-30 |
| Last Update Date | 2025-10-15 |