| NPI | 1174755953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: TX Q6339) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 099166) |
| 208M00000X Hospitalist (Licence: OH 099166) | |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2022-06-16 |