| NPI | 1457372971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2006015221) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2006015221) |
| 207R00000X Internal Medicine (Licence: KS 04-31897) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2016-12-27 |