| NPI | 1750346482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OR MD171953) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 25887) |
| 208000000X Pediatrics (Licence: KY 25887) | |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2016-04-29 |