| NPI | 1740369453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 36014) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 36014) |
| 207R00000X Internal Medicine (Licence: CA A53030) | |
| 208M00000X Hospitalist (Licence: CA A53030) | |
| 208M00000X Hospitalist (Licence: WI 36014) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: WI 36014) | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2021-04-02 |