| NPI | 1336308964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 30946) |
| Additional Taxonomies | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: SC 30946) |
| 207R00000X Internal Medicine (Licence: SC LL30946) | |
| 208000000X Pediatrics (Licence: SC LL30946) | |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2019-05-15 |