| NPI | 1104088947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2011019882) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 9407056) |
| 207R00000X Internal Medicine (Licence: MO 2011019882) | |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2016-12-27 |