| NPI | 1821358003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 73446) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2015021659) |
| 207R00000X Internal Medicine (Licence: GA 005442) | |
| 207R00000X Internal Medicine (Licence: KS 0439088) | |
| 208M00000X Hospitalist (Licence: GA 73446) | |
| 208M00000X Hospitalist (Licence: MO 2015021659) | |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2022-08-25 |