| NPI | 1972820090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2024000701) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK DO) |
| 208M00000X Hospitalist (Licence: MO 2024000701) | |
| Enumeration Date | 2010-04-29 |
| Last Update Date | 2025-08-27 |