| NPI | 1710144761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 0435266) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME104270) |
| 207R00000X Internal Medicine (Licence: CO 46377) | |
| 208M00000X Hospitalist (Licence: FL ME104270) | |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2020-07-30 |