| NPI | 1669601522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101261424) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101261424) |
| 208M00000X Hospitalist (Licence: VA 0101261424) | |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2023-11-27 |