| NPI | 1619556172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 83667) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 83667) |
| 207R00000X Internal Medicine (Licence: UT 12974706-1205) | |
| Enumeration Date | 2021-04-03 |
| Last Update Date | 2024-08-28 |