| NPI | 1578177614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 87808-020) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD480825) |
| 207R00000X Internal Medicine (Licence: WI 87808-020) | |
| Enumeration Date | 2020-09-05 |
| Last Update Date | 2026-08-19 |