| NPI | 1649579186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2022048592) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 29165) |
| 207R00000X Internal Medicine (Licence: KS 94-09774) | |
| 207R00000X Internal Medicine (Licence: IA MD-43711) | |
| 208M00000X Hospitalist (Licence: IA MD-43711) | |
| Enumeration Date | 2011-03-23 |
| Last Update Date | 2023-11-06 |