| NPI | 1487148367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2022-01821) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL52462) |
| 207R00000X Internal Medicine (Licence: SC LL52462) | |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2022-08-16 |