| NPI | 1649362161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2006020237) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 05-31370) |
| 207R00000X Internal Medicine (Licence: MO 2006020237) | |
| 208M00000X Hospitalist (Licence: KS 05-31370) | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2020-04-07 |