| NPI | 1760536650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KS 04-32402) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2008007036) |
| 208M00000X Hospitalist (Licence: MO 2008007036) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2021-01-25 |