| NPI | 1881019057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 14098330-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036161668) |
| 208D00000X General Practice (Licence: VA 0101258937) | |
| Enumeration Date | 2014-02-25 |
| Last Update Date | 2025-02-25 |