| NPI | 1407098577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AK 7816) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT 67235) |
| 207R00000X Internal Medicine (Licence: AK 7780) | |
| 208000000X Pediatrics (Licence: AK 7780) | |
| Enumeration Date | 2009-04-03 |
| Last Update Date | 2021-10-06 |