| NPI | 1538136692 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A74404) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A74404) | 
| Enumeration Date | 2006-03-07 | 
| Last Update Date | 2010-10-19 |