| NPI | 1881075513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OR MD186365) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 85995-20) |
| 207R00000X Internal Medicine (Licence: MN 79294) | |
| 207R00000X Internal Medicine (Licence: ID 8271451) | |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2025-08-27 |