| NPI | 1316689813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TN 6037) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA 000) |
| 208M00000X Hospitalist (Licence: GA 111481) | |
| Enumeration Date | 2022-04-13 |
| Last Update Date | 2026-08-21 |