| NPI | 1194187617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 103874-875) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MN 66350) |
| 207R00000X Internal Medicine (Licence: WI 103874-875) | |
| 207R00000X Internal Medicine (Licence: MN 66350) | |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2026-07-01 |