| NPI | 1851779920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2020007033) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2020007033) |
| 208M00000X Hospitalist (Licence: IL 036-145274) | |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2022-11-07 |