| NPI | 1578913943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2018043061) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2018043061) |
| 208D00000X General Practice (Licence: MO 2018043061) | |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2024-04-25 |