| NPI | 1710327549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2017-02376) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT205176) |
| 207R00000X Internal Medicine (Licence: WI 85324) | |
| 208M00000X Hospitalist (Licence: VA 0101260677) | |
| 208M00000X Hospitalist (Licence: NC 2017-02376) | |
| 208M00000X Hospitalist (Licence: WI 85324) | |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2025-06-13 |