| NPI | 1104232610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME166641) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 64763) |
| 207R00000X Internal Medicine (Licence: GA 103549) | |
| 208M00000X Hospitalist (Licence: WI 64763-20) | |
| 208M00000X Hospitalist (Licence: LA 345476) | |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2025-07-16 |