| NPI | 1235593674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 82604) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AZ 58172) |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2026-06-10 |