| NPI | 1861874000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX S3037) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35134223) |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2021-09-08 |