| NPI | 1396765426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 25528) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 25528) |
| 207RA0000X Internal Medicine Adolescent Medicine (Licence: SC 25528) | |
| 208000000X Pediatrics (Licence: SC 25528) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2019-05-21 |