| NPI | 1124321658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 64433-20) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 2011018947) |
| Enumeration Date | 2010-12-06 |
| Last Update Date | 2018-03-17 |