| NPI | 1609255082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 81739) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WV 3103) |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2019-03-02 |