| NPI | 1114117892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2009014119) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2009014119) |
| 207R00000X Internal Medicine (Licence: IL 036117958) | |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2019-01-23 |