| NPI | 1063875623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME139242) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: ND PT20111) |
| 207R00000X Internal Medicine (Licence: MN 81262) | |
| 208M00000X Hospitalist (Licence: MT 166808) | |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2026-02-24 |