| NPI | 1952985467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101282983) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101282983) |
| 208M00000X Hospitalist (Licence: KY 59915) | |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2025-05-15 |