| NPI | 1659369742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2017-02296) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2017-02296) |
| 207R00000X Internal Medicine (Licence: MA 208663) | |
| 208000000X Pediatrics (Licence: MA 208663) | |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2018-05-04 |