| NPI | 1245691161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 25610) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MS 25610) |
| 208000000X Pediatrics (Licence: MS 25610) | |
| Enumeration Date | 2016-03-20 |
| Last Update Date | 2020-08-21 |