| NPI | 1982130753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME140140) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN24728) |
| 208M00000X Hospitalist (Licence: AZ 66123) | |
| 208M00000X Hospitalist (Licence: WI 77871) | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2023-06-20 |