| NPI | 1871858548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 29189) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.141115) |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: OK 29189) | |
| 208M00000X Hospitalist (Licence: MN 68034) | |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2024-01-15 |