| NPI | 1245791482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 101697) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MN 71869) |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2024-09-06 |