| NPI | 1821619792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 75474) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: ND PT20231) |
| Enumeration Date | 2020-05-02 |
| Last Update Date | 2025-09-17 |