| NPI | 1700272234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TN 75234) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 2023-01513) |
| 208M00000X Hospitalist (Licence: IL 036-146951) | |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2026-05-13 |