| NPI | 1063509099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 27256) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 2527256) |
| 208000000X Pediatrics (Licence: SC 2527256) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2016-06-17 |