| NPI | 1720078652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME82064) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AZ 64632) |
| Enumeration Date | 2005-10-22 |
| Last Update Date | 2022-01-25 |