| NPI | 1194788158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A74116) |
| Additional Taxonomies | 207RH0002X Internal Medicine Hospice and Palliative Medicine (Licence: CA A74116) |
| 208000000X Pediatrics (Licence: CA A74116) | |
| 208M00000X Hospitalist (Licence: CA A74116) | |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2023-03-28 |