| NPI | 1518514371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MD R207580) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: MD R207580) |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2022-07-27 |