| NPI | 1902286743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS22069) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: GA 080840) |
| 207R00000X Internal Medicine (Licence: GA 80840) | |
| 207R00000X Internal Medicine (Licence: FL UO 4532) | |
| Enumeration Date | 2015-06-07 |
| Last Update Date | 2025-09-19 |