| NPI | 1972745115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NM MD2012-0570) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2012-07570) |
| Enumeration Date | 2009-04-02 |
| Last Update Date | 2025-06-18 |