| NPI | 1972665529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2009-01278) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 2009-01278) |
| 208M00000X Hospitalist (Licence: VA 0101245537) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2026-04-16 |