| NPI | 1912953241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO R8746) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO R8746) |
| 207R00000X Internal Medicine (Licence: KS 05-32792) | |
| 208M00000X Hospitalist (Licence: KS 05-32792) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2017-01-04 |