| NPI | 1710440193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2022025546) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2022025516) |
| 208M00000X Hospitalist (Licence: IL 036161493) | |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2022-08-22 |