| NPI | 1235563321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 202101646) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: GA 109372) |
| Enumeration Date | 2013-08-26 |
| Last Update Date | 2025-08-27 |