| NPI | 1942887161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME167243) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A189384) |
| 208M00000X Hospitalist (Licence: DC MD500002993) | |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2024-07-29 |