| NPI | 1811376288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 84124) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 84124-20) |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2025-10-23 |