| NPI | 1003858747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2009024737) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-25722) |
| 207R00000X Internal Medicine (Licence: MO 2009024737) | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2017-04-05 |