| NPI | 1912909508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 30789) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MS 21896) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MS 218961) | |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2025-09-29 |