| NPI | 1679135669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101280314) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AZ 70814) |
| Enumeration Date | 2019-07-01 |
| Last Update Date | 2026-02-09 |