| NPI | 1477566149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 200100474) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 200100474) |
| 208000000X Pediatrics (Licence: NC 200100474) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2017-03-16 |