| NPI | 1023214509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2015000100) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2015000100) |
| 208M00000X Hospitalist (Licence: KS 05-35676) | |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2017-10-19 |