| NPI | 1043504251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 38083) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT199984) |
| 207R00000X Internal Medicine (Licence: SC 38083) | |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2023-06-14 |