| NPI | 1376890392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 64284) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MN 59436) |
| 207R00000X Internal Medicine (Licence: MN 59436) | |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2024-02-14 |