NPI | 1700520269 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208M00000X Hospitalist (Licence: MI 5101028163) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101028163) |
208D00000X General Practice (Licence: MI 5101028163) | |
Enumeration Date | 2022-04-21 |
Last Update Date | 2025-07-22 |