| NPI | 1922591072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 13460320) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT216476) |
| 207R00000X Internal Medicine (Licence: VA 0101276107) | |
| 207R00000X Internal Medicine (Licence: MD D0091913) | |
| 208M00000X Hospitalist (Licence: VA 0101276107) | |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2026-03-24 |