| NPI | 1477693901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NM MD2015-0025) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301100204) |
| 207R00000X Internal Medicine (Licence: KS 04-39330) | |
| 208D00000X General Practice (Licence: NC 2006-00244) | |
| 208M00000X Hospitalist (Licence: KS 04-39330) | |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2023-08-17 |