| NPI | 1861012668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX U8656) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AZ 79479) |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2026-09-15 |