| NPI | 1841873601 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 83675) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL83675) | 
| Enumeration Date | 2021-04-29 | 
| Last Update Date | 2024-07-18 |