| NPI | 1639256571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 54959) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KY TP839) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2026-08-23 |