| NPI | 1427641638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9117095) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 0010-10993) |
| Enumeration Date | 2021-02-18 |
| Last Update Date | 2023-03-27 |