| NPI | 1306293352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OR MD203961) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR MD203961) |
| 207R00000X Internal Medicine (Licence: OR MD203961) | |
| 207R00000X Internal Medicine (Licence: AZ 56942) | |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2021-06-28 |