| NPI | 1891925152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2012018949) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 9407192) |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2016-12-21 |