| NPI | 1164440319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 423982) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 4-23982) |
| 207R00000X Internal Medicine (Licence: NC 20113-02022) | |
| 208M00000X Hospitalist (Licence: NC 2013-02022) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2018-03-17 |