| NPI | 1649473331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2008035006) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH 13549) |
| 207R00000X Internal Medicine (Licence: MO 2008035006) | |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2022-01-05 |