| NPI | 1013390723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX T1752) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IA MD-45045) |
| 208M00000X Hospitalist (Licence: NE 30951) | |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2022-05-16 |