| NPI | 1992779433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 39706-020) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA MD.203446) |
| 207P00000X Emergency Medicine (Licence: MS 20260) | |
| 207R00000X Internal Medicine (Licence: WI 39706-020) | |
| 208000000X Pediatrics (Licence: WI 39706-020) | |
| 208M00000X Hospitalist (Licence: MA MD.203446) | |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2020-02-12 |