| NPI | 1962631655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: HI MD16791) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI 16791) |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2026-01-29 |