| NPI | 1992411664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CT 80263) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10079537) |
| Enumeration Date | 2023-01-26 |
| Last Update Date | 2025-10-09 |