| NPI | 1336210608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA G79666) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA G079666) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2020-12-14 |