| NPI | 1164783700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OK 29387) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 29387) |
| 208M00000X Hospitalist (Licence: MN 65522) | |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2024-08-06 |