| NPI | 1902095128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WA 60555449) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IN 01099046A) |
| 208M00000X Hospitalist (Licence: KY C5250) | |
| 207R00000X Internal Medicine (Licence: MA 231032) | |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2026-06-17 |