| NPI | 1659377265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: LA 14260R) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 14260R) |
| 207R00000X Internal Medicine (Licence: TX M9066) | |
| 208000000X Pediatrics (Licence: LA 14260R) | |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2021-05-12 |