| NPI | 1972851335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WV 30642) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 62229) |
| 207R00000X Internal Medicine (Licence: WI 62229) | |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2025-08-12 |