| NPI | 1467656272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MI 4301098069) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301098069) |
| 208000000X Pediatrics (Licence: MI 4301098069) | |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2022-04-23 |