| NPI | 1235430935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL PA1501) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA1501) |
| Enumeration Date | 2010-11-11 |
| Last Update Date | 2023-09-26 |