| NPI | 1497040679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 33549) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 33549) |
| 208000000X Pediatrics (Licence: SC 33549) | |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2021-06-12 |