| NPI | 1629704556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NE 36978) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IA MD-55194) |
| Enumeration Date | 2022-07-25 |
| Last Update Date | 2025-07-22 |