| NPI | 1992221808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NE 7999) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KS 04-43435) |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2025-09-08 |