| NPI | 1972180735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 81367-21) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: WI 7011195) |
| 207R00000X Internal Medicine (Licence: NY 320416) | |
| 207R00000X Internal Medicine (Licence: WI 81367-21) | |
| 208M00000X Hospitalist (Licence: NY 320416) | |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2024-05-07 |