| NPI | 1972910164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 311716-01) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 66871) |
| 207R00000X Internal Medicine (Licence: NY 311716-01) | |
| Enumeration Date | 2014-07-20 |
| Last Update Date | 2026-01-09 |