| NPI | 1740740679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2022013219) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KS 04-51335) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2026-02-24 |