| NPI | 1174878219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KS 0448632) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 0055821) |
| 207R00000X Internal Medicine (Licence: KS 0448632) | |
| 208M00000X Hospitalist (Licence: CO DR.0055821) | |
| 208M00000X Hospitalist (Licence: UT 13161930-1205) | |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2024-01-04 |