| NPI | 1295026607 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MD D0104200) | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WV 35253) | 
| 208M00000X Hospitalist (Licence: AZ 74871) | |
| 208M00000X Hospitalist (Licence: OH 35.123647) | |
| Enumeration Date | 2011-04-20 | 
| Last Update Date | 2025-10-14 |