| NPI | 1801357561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CO DR.0069036) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 76475) |
| 207R00000X Internal Medicine (Licence: FL ME174092) | |
| 207R00000X Internal Medicine (Licence: CO DR.0069036) | |
| 207R00000X Internal Medicine (Licence: NY 345308) | |
| 207R00000X Internal Medicine (Licence: MN 82081) | |
| 207R00000X Internal Medicine (Licence: KY C4962) | |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2026-08-26 |