| NPI | 1336102979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 25598) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 25598) |
| 207R00000X Internal Medicine (Licence: UT 4811012-1205) | |
| 208000000X Pediatrics (Licence: UT 4811012-1205) | |
| 208M00000X Hospitalist (Licence: CO 48044) | |
| 208M00000X Hospitalist (Licence: NE 26011) | |
| 208M00000X Hospitalist (Licence: UT 4811012-1205) | |
| 208M00000X Hospitalist (Licence: MO 2025001465) | |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2025-07-28 |