| NPI | 1871243600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IA MD-54841) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 34047) |
| 207R00000X Internal Medicine (Licence: IA MD-54841) | |
| Enumeration Date | 2022-03-25 |
| Last Update Date | 2025-07-23 |