| NPI | 1558885871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 90979) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2022003459) |
| 208000000X Pediatrics (Licence: GA 90979) | |
| 208M00000X Hospitalist (Licence: GA 90979) | |
| Enumeration Date | 2017-07-28 |
| Last Update Date | 2022-07-20 |