| NPI | 1730189499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME119775) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01039483) |
| 208M00000X Hospitalist (Licence: WI 62200-20) | |
| 208M00000X Hospitalist (Licence: IN 01039483) | |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2025-04-10 |