| NPI | 1881074250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CT 62066) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301507570) |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2026-06-16 |