| NPI | 1548766223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2021015389) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WY 18207C) |
| 207R00000X Internal Medicine (Licence: NE 8215) | |
| 207R00000X Internal Medicine (Licence: CO CDR.0002413) | |
| 208M00000X Hospitalist (Licence: MN 73173) | |
| 208M00000X Hospitalist (Licence: WI 13145) | |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2025-08-28 |