| NPI | 1164843553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX Q2363) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NJ 25MA09470700) |
| Enumeration Date | 2014-01-02 |
| Last Update Date | 2019-03-18 |