| NPI | 1952415846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 50147) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 50147) |
| 207RG0300X Internal Medicine Geriatric Medicine (Licence: FL ME98096) | |
| 208000000X Pediatrics (Licence: MA 229512) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2025-05-23 |