| NPI | 1154983666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 76940) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125073892) |
| Enumeration Date | 2019-07-03 |
| Last Update Date | 2026-04-09 |