| NPI | 1053376301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 105963) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KS 04-33185) |
| 207R00000X Internal Medicine (Licence: MO 1053376301) | |
| 207R00000X Internal Medicine (Licence: KS 04-33185) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2017-01-16 |