| NPI | 1740577766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 68257) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX provisional license) |
| 207R00000X Internal Medicine (Licence: WI 68257) | |
| 208M00000X Hospitalist (Licence: ME MD20217) | |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2017-12-13 |