NPI | 1245626522 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 288730) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 288730) |
207R00000X Internal Medicine (Licence: WI 56789) | |
Enumeration Date | 2015-04-13 |
Last Update Date | 2025-06-11 |