| NPI | 1790164127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NM MD2021-1123) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: DC MTL003210) |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2022-02-01 |