| NPI | 1184253700 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 74477) | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 75749) | 
| Enumeration Date | 2020-04-06 | 
| Last Update Date | 2023-09-22 |