| NPI | 1225428584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01082985A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 64023-20) |
| 207R00000X Internal Medicine (Licence: MI 4301108787) | |
| 208M00000X Hospitalist (Licence: MI 4301108787) | |
| 208M00000X Hospitalist (Licence: WI 64023) | |
| 208M00000X Hospitalist (Licence: OH 35129675) | |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2020-12-09 |