| NPI | 1811414626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2020022085) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2020022085) |
| 207R00000X Internal Medicine (Licence: IL 125070086) | |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2021-01-29 |