| NPI | 1265779342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A132625) |
| Additional Taxonomies | 207RA0000X Internal Medicine Adolescent Medicine (Licence: CA A132625) |
| 207RA0000X Internal Medicine Adolescent Medicine (Licence: RI MD 14292) | |
| Enumeration Date | 2013-01-10 |
| Last Update Date | 2021-09-24 |