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 |