| NPI | 1790726222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2012017692) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 3787) |
| 208M00000X Hospitalist (Licence: OK 3787) | |
| 207R00000X Internal Medicine (Licence: MO 2012017692) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2017-04-06 |