| NPI | 1801857636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX M5267) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX M5267) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2020-10-14 |