| NPI | 1891374484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2025-00451) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME171015) |
| Enumeration Date | 2021-04-02 |
| Last Update Date | 2025-06-17 |