| NPI | 1760758569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 81981) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 61867) |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2020-11-24 |