| NPI | 1629388475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 64649) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT 194536) |
| 207R00000X Internal Medicine (Licence: WI 64649) | |
| Enumeration Date | 2010-10-14 |
| Last Update Date | 2022-11-17 |