| NPI | 1639142599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2004025486) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2004025486) |
| 207R00000X Internal Medicine (Licence: AL MD.25598) | |
| 207P00000X Emergency Medicine (Licence: AL MD.25598) | |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2010-01-08 |