| NPI | 1164458121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101053721) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 2018-03045) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2024-09-30 |