| NPI | 1780179101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 83182-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ND RL15149) |
| 208M00000X Hospitalist (Licence: ND 17662) | |
| 207R00000X Internal Medicine (Licence: WI 83182-20) | |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2026-02-27 |