| NPI | 1770880536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX R0218) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX R0218) |
| 207R00000X Internal Medicine (Licence: NJ 25MA08995400) | |
| Enumeration Date | 2011-02-14 |
| Last Update Date | 2025-05-14 |