| NPI | 1558063750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS23684) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL OS23684) |
| Enumeration Date | 2023-03-20 |
| Last Update Date | 2026-06-15 |