| NPI | 1932399615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA 61542416) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX Q9803) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2025-05-01 |