| NPI | 1205142908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A118611) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A118611) |
| 208000000X Pediatrics (Licence: CA A118611) | |
| Enumeration Date | 2010-08-19 |
| Last Update Date | 2018-04-02 |