| NPI | 1275745333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL PA9102828) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA 9102828) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2026-04-16 |