| NPI | 1992425896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A21809) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA 20A21809) |
| 208M00000X Hospitalist (Licence: CA 20A21809) | |
| Enumeration Date | 2022-08-31 |
| Last Update Date | 2026-06-24 |