| NPI | 1972036721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0097171) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MD D0097171) |
| 208M00000X Hospitalist (Licence: GA 85548) | |
| Enumeration Date | 2017-04-08 |
| Last Update Date | 2025-08-12 |