| NPI | 1275575581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ND 15751) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 49204) |
| 207Q00000X Family Medicine (Licence: ND 15751) | |
| 207Q00000X Family Medicine (Licence: IN 01082211A) | |
| 207Q00000X Family Medicine (Licence: WY 7369A) | |
| 208M00000X Hospitalist (Licence: LA 339848) | |
| 208M00000X Hospitalist (Licence: IN 01082211A) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2024-06-05 |