| NPI | 1548319932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: DE C10003898) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD044311E) |
| 208D00000X General Practice (Licence: PA MD044311E) | |
| 208M00000X Hospitalist (Licence: PA MD044311E) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2011-09-21 |