NPI | 1508068495 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 44564) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 44564) |
207R00000X Internal Medicine (Licence: DE C7-0003789) | |
208000000X Pediatrics (Licence: AZ 44564) | |
208000000X Pediatrics (Licence: DE C7-0003789) | |
Enumeration Date | 2007-06-03 |
Last Update Date | 2021-03-30 |