| NPI | 1699185702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 56021) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 56021) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TN 56021) | |
| 208M00000X Hospitalist (Licence: TN 56021) | |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2018-07-19 |