| NPI | 1790085223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A123430) |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: CA A123430) |
| 208M00000X Hospitalist (Licence: CA A123430) | |
| Enumeration Date | 2010-11-01 |
| Last Update Date | 2026-07-21 |