| NPI | 1932738598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101287780) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35.147977) |
| 208M00000X Hospitalist (Licence: NM MD2025-0132) | |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2026-03-11 |