| NPI | 1871977314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 57662) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301117200) |
| 208M00000X Hospitalist (Licence: TN 0000057122) | |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2026-01-09 |