| NPI | 1780879783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MD C03508) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C03508) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2019-10-21 |