| NPI | 1679744809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2011006614) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125050620) |
| 207R00000X Internal Medicine (Licence: MO 2011006614) | |
| Enumeration Date | 2008-03-15 |
| Last Update Date | 2017-05-09 |