| NPI | 1558356923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OK 24907) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 24907) |
| 207R00000X Internal Medicine (Licence: MO 116786) | |
| 207R00000X Internal Medicine (Licence: KS 04-30374) | |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2019-02-08 |