| NPI | 1912394040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD221263) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NH 18816) |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2025-01-23 |