| NPI | 1831536036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 84857) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TN 54874) |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2025-09-17 |