NPI | 1720181282 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C150323) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 13840) |
208000000X Pediatrics (Licence: PR 13840) | |
208M00000X Hospitalist (Licence: PR 13840) | |
Enumeration Date | 2006-09-07 |
Last Update Date | 2022-02-11 |