| NPI | 1982023180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2024-00345) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 281193) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2025-12-24 |