| NPI | 1811516933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2025-02027) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TN 68797) |
| 207R00000X Internal Medicine (Licence: TN 68797) | |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2026-06-15 |