| NPI | 1538472899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: LA 341649) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01083618A) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: OK 30134) | |
| 207Q00000X Family Medicine (Licence: MO 2010020758) | |
| 208M00000X Hospitalist (Licence: OK 30134) | |
| 208M00000X Hospitalist (Licence: IN 01083618A) | |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2025-09-26 |