| NPI | 1548586555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 57042) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 57042) |
| 208000000X Pediatrics (Licence: WI 57042) | |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2016-06-23 |