| NPI | 1417332479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2023018525) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D84678) |
| 207R00000X Internal Medicine (Licence: MO 2023018525) | |
| 207R00000X Internal Medicine (Licence: MA 263792) | |
| 208M00000X Hospitalist (Licence: MD D84678) | |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2023-11-17 |