| NPI | 1013114131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2018000535) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2018000535) |
| 207R00000X Internal Medicine (Licence: KS 046827) | |
| 207R00000X Internal Medicine (Licence: NH 14705) | |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2018-03-17 |