| NPI | 1942884085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 104075) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 104075) |
| Enumeration Date | 2021-05-05 |
| Last Update Date | 2025-10-04 |