| 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 |