| NPI | 1346286788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VT 0420011092) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VT 042-0011092) |
| 208000000X Pediatrics (Licence: VT 042-0011092) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2014-10-08 |