| NPI | 1063904795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 78038) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX T1223) |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2025-03-12 |