| NPI | 1457681306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2023-02313) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2017018911) |
| 208000000X Pediatrics (Licence: NC 2023-02313) | |
| 208M00000X Hospitalist (Licence: MO 2017018911) | |
| Enumeration Date | 2009-12-28 |
| Last Update Date | 2024-01-24 |