| NPI | 1164153987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2025033504) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KS 0551437) |
| Enumeration Date | 2022-06-22 |
| Last Update Date | 2025-09-15 |