| NPI | 1922397686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 56432) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 68153) |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2025-01-30 |