| NPI | 1659477131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: DE C10003946) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DE C10003946) |
| 208M00000X Hospitalist (Licence: DE C10003946) | |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2012-01-06 |