| NPI | 1184882102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: IA 4318) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 4318) |
| 208000000X Pediatrics (Licence: IA 4318) | |
| 208M00000X Hospitalist (Licence: IA 4318) | |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2022-10-11 |