| NPI | 1285818518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A98159) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A98159) |
| 208000000X Pediatrics (Licence: CA A98159) | |
| Enumeration Date | 2007-12-21 |
| Last Update Date | 2017-03-17 |