| NPI | 1255958914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 82614-20) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 82614-20) |
| Enumeration Date | 2020-06-29 |
| Last Update Date | 2024-04-22 |