| NPI | 1801478219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 33843) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KS 0452044) |
| Enumeration Date | 2021-04-25 |
| Last Update Date | 2025-10-28 |