| NPI | 1558855767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OR MD209619) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.072962) |
| 208000000X Pediatrics (Licence: IL 125.072962) | |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2022-07-20 |