| NPI | 1114920162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 200101440) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 200101440) |
| 208M00000X Hospitalist (Licence: SC 87299) | |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2022-10-12 |