| NPI | 1144431925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2014015794) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 26807) |
| 207R00000X Internal Medicine (Licence: OK 26807) | |
| 207R00000X Internal Medicine (Licence: MO 2014015794) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2021-01-19 |