| NPI | 1114186350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA C149128) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA C149128) |
| 208000000X Pediatrics (Licence: CA C149128) | |
| 208000000X Pediatrics (Licence: NC 2012-00688) | |
| 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: CA C149128) | |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2019-02-22 |