| NPI | 1740223635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TN 28960) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN MD28960) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2025-09-15 |