| NPI | 1235187899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2008022454) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2008022454) |
| 207R00000X Internal Medicine (Licence: MO 2008022454) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2026-04-11 |