| NPI | 1831621853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2021-00119) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2021-00119) |
| 207R00000X Internal Medicine (Licence: SC LL40997) | |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2026-06-22 |