| NPI | 1972065712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 86723) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KY 56756) |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2026-07-29 |