| NPI | 1962891317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 84617) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: SC 37886) |
| 208M00000X Hospitalist (Licence: GA 84617) | |
| 207R00000X Internal Medicine (Licence: SC 37886) | |
| Enumeration Date | 2015-01-22 |
| Last Update Date | 2026-05-26 |