| NPI | 1922267582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD492059C) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 52220) |
| 207R00000X Internal Medicine (Licence: NH 16444) | |
| Enumeration Date | 2008-06-08 |
| Last Update Date | 2025-09-30 |