| NPI | 1891133450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A132056) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A132056) |
| 207R00000X Internal Medicine (Licence: CA zeros) | |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2025-07-08 |