| NPI | 1588874820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2005020210) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2005020210) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2021-03-12 |