| NPI | 1568983229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2020010663) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KS 05-47959) |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2026-05-26 |