| NPI | 1376837195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OR DO173871) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MN 58124) |
| 207R00000X Internal Medicine (Licence: MI 5101019442) | |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2023-03-07 |