| NPI | 1013125939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CO CDRH.0048642) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 48642) |
| 208000000X Pediatrics (Licence: CO CDRH.0048642) | |
| 208M00000X Hospitalist (Licence: MT 83394) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2025-05-20 |