| NPI | 1295933125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2015032515) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 9406850) |
| 207R00000X Internal Medicine (Licence: MO 2015032515) | |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2017-03-31 |