| NPI | 1497799621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2007006878) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KS 05-33062) |
| 207R00000X Internal Medicine (Licence: MO 2007006878) | |
| 207R00000X Internal Medicine (Licence: KS 05-33062) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2016-12-21 |