| NPI | 1073997839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2018023698) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-156813) |
| 207RN0300X Internal Medicine, Nephrology (Licence: MO 2018023698) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: IL 036-156813) | |
| 208M00000X Hospitalist (Licence: IL 036-156813) | |
| Enumeration Date | 2015-07-11 |
| Last Update Date | 2021-07-02 |