| NPI | 1265679724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 63762-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 63762-20) |
| 208M00000X Hospitalist (Licence: MN 52838) | |
| 208M00000X Hospitalist (Licence: OR 168654) | |
| Enumeration Date | 2009-01-20 |
| Last Update Date | 2021-12-13 |