| NPI | 1104808294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AL 42356) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: GA 056310) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2021-04-12 |