| NPI | 1366443756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2001032147) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2001032147) |
| 208M00000X Hospitalist (Licence: MO 2001032147) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2014-05-08 |