| NPI | 1831564319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MD C0005936) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C05936) |
| Enumeration Date | 2015-12-09 |
| Last Update Date | 2018-01-05 |