| NPI | 1467800755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2020010485) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 94-08969) |
| 207R00000X Internal Medicine (Licence: MO 2020010485) | |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2020-11-19 |