| NPI | 1336240696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ID M15613) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 28113) |
| 208000000X Pediatrics (Licence: KS 28113) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2021-03-29 |