| NPI | 1790218857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NV 19965) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TN 63990) |
| 207R00000X Internal Medicine (Licence: NV 19965) | |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2026-09-05 |