NPI | 1043519598 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2015014693) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2015014693) |
207R00000X Internal Medicine (Licence: KS 0438039) | |
208000000X Pediatrics (Licence: KS 0438039) | |
208000000X Pediatrics (Licence: MO 2015014693) | |
Enumeration Date | 2011-03-23 |
Last Update Date | 2021-03-25 |