| NPI | 1477808426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WV 29344) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D80343) |
| 208000000X Pediatrics (Licence: MD D80343) | |
| 208M00000X Hospitalist (Licence: MD D80343) | |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2020-01-02 |