| NPI | 1144602111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2017034294) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2017034294) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2019-09-23 |