| NPI | 1932493731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2019021893) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY TP510) |
| 208M00000X Hospitalist (Licence: MN 61340) | |
| 208M00000X Hospitalist (Licence: KY TP510) | |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2021-02-01 |