| NPI | 1629656327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 87453-020) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 87453-020) | |
| 207R00000X Internal Medicine (Licence: CA 194326) | |
| 208M00000X Hospitalist (Licence: OH 35.149008) | |
| 208M00000X Hospitalist (Licence: CA 194326) | |
| 207R00000X Internal Medicine (Licence: OH 35.149008) | |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2026-07-02 |