| NPI | 1679571772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 9300278) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 9300278) |
| 208000000X Pediatrics (Licence: NC 9300278) | |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2017-02-21 |