| NPI | 1649312208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 62973) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 62973-20) |
| 207R00000X Internal Medicine (Licence: IL 036117006) | |
| 207R00000X Internal Medicine (Licence: MN 63119) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2024-12-05 |