| NPI | 1457964389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME181170) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 75865) |
| Enumeration Date | 2020-08-29 |
| Last Update Date | 2026-05-11 |