| NPI | 1538555701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2017036837) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2015020134) |
| 208000000X Pediatrics (Licence: MO 2015020134) | |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2019-08-30 |