| NPI | 1215910500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME90754) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 73189) |
| 208M00000X Hospitalist (Licence: AZ 62509) | |
| 208M00000X Hospitalist (Licence: MN 68031) | |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2021-05-10 |