| NPI | 1891153441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MS 901451) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: MS 901451) |
| Enumeration Date | 2016-02-10 |
| Last Update Date | 2023-11-21 |