| NPI | 1861749731 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D75118)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101263558)  | 
| 208M00000X Hospitalist (Licence: MD D75118)  | |
| Enumeration Date | 2012-08-10 | 
| Last Update Date | 2025-08-12 |