| NPI | 1194213363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 8154120) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 8154120) |
| 208D00000X General Practice (Licence: MI 4301507842) | |
| 208M00000X Hospitalist (Licence: WI 81541) | |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2023-08-16 |