| NPI | 1174835854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2013028525) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KS 05-36715) |
| Enumeration Date | 2010-07-09 |
| Last Update Date | 2017-01-04 |