| NPI | 1770558553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: IA 46174) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-44632) |
| 207R00000X Internal Medicine (Licence: NC 9701241) | |
| 208M00000X Hospitalist (Licence: KS 04-44632) | |
| 208M00000X Hospitalist (Licence: SD 76934) | |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2024-07-01 |