| NPI | 1619970068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA C50896) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA C50896) |
| 208000000X Pediatrics (Licence: CA C50896) | |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2022-05-25 |