| NPI | 1770288110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC LL90267) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: GA 111492) |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2026-06-05 |