| NPI | 1417174186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 060549) |
| Additional Taxonomies | 207SG0201X Medical Genetics Clinical Genetics (M.D.) (Licence: GA 060549) |
| 207ZC0006X Pathology Clinical Pathology (Licence: MN 53443) | |
| 207ZC0006X Pathology Clinical Pathology (Licence: MN 105011) | |
| 208M00000X Hospitalist (Licence: WI 50398-20) | |
| 208M00000X Hospitalist (Licence: NH 13465) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2025-08-06 |