| NPI | 1891821997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2009023888) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35088180) |
| 207R00000X Internal Medicine (Licence: MO 2009023888) | |
| 208000000X Pediatrics (Licence: OH 35-088180) | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2021-02-26 |