| NPI | 1962142364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MA 1023578) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CO DR.0072042) |
| 207R00000X Internal Medicine (Licence: CO DR.0072042) | |
| Enumeration Date | 2022-04-01 |
| Last Update Date | 2026-01-09 |