| NPI | 1366861148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2017-02242) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX Bp10049211) |
| 208000000X Pediatrics (Licence: TX Bp10049211) | |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2019-02-05 |