| NPI | 1093791097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 35521) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 35521) |
| 207R00000X Internal Medicine (Licence: MD D0059987) | |
| 208000000X Pediatrics (Licence: MD D0059987) | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2019-05-20 |