| NPI | 1922108653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ND 11592) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 46495) |
| 207R00000X Internal Medicine (Licence: MN 49181) | |
| 207R00000X Internal Medicine (Licence: ND 11592) | |
| Enumeration Date | 2006-09-23 |
| Last Update Date | 2023-07-23 |