| NPI | 1174901615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 69328) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 69328) |
| Enumeration Date | 2015-05-17 |
| Last Update Date | 2024-07-21 |