| NPI | 1992437909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA8841) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MA PA8841) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2022-10-28 |