| NPI | 1962935585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 101069) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: GA 101069) |
| 207R00000X Internal Medicine (Licence: SC 83393) | |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2026-01-26 |