| NPI | 1417189671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: TX R6808) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA MD60278638) |
| 208000000X Pediatrics (Licence: WA MD60278638) | |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2024-06-11 |